| 總結: | <p><strong>Systematic Review of the Literature</strong></p>
<p><strong>Understanding the psychosocial impact of a child’s cleft lip and/or palate on family members and familial relationships: a systematic review</strong></p>
<p>A child’s cleft lip and/or palate (CL/P) may have psychosocial effects on them, but also their family. This review examines the psychosocial impact of a CL/P on children’s families and familial relationships compared to having a child born without CL/P. We systematically reviewed 21 quantitative studies. Studies measured outcomes that broadly fit into five areas: parental mental health, parenting stress, quality of life, family functioning, and parent-child relationships. Findings were mixed, with some evidence indicating that having a child born with a CL/P is linked to negative psychosocial outcomes, and some suggesting no significant differences in those outcomes between parents of children born without a CL/P and parents of children born with a CL/P. This could be because studies were highly heterogenous in the outcome measures used and variables that were measured and controlled for. We conclude with a discussion of limitations of included studies and of this review, and suggestions for further research, such as studying what factors separate families of children born with CL/P who are impacted psychosocially more than others.</p></br>
<p><strong>Service Improvement Project</strong></p>
<p><strong>Young People’s Supported Accommodation (YPSA) Service: Understanding the experiences of young people in need of support for managing interpersonal relationships</strong></p>
<p><em>Background:</em> Existing literature highlights the additional needs that young people (YP) in supported accommodation have with regards to understanding and forming healthy relationships. This project aimed to investigate the relationship support needs of YP in the Oxfordshire Young People’s Supported Accommodation (YPSA) service from staff and YP perspectives, and to consider what type of interventions and materials might be most suitable for addressing those needs.</p>
<p><em>Methods:</em> Semi-structured interviews and a focus group were held with 10 YPSA residents aged 18-24 and 4 staff members. Thematic analysis was conducted separately for YP and staff data.</p>
<p><em>Results:</em> Three main themes emerged from YP: 1) mixed experiences of interpersonal relationships, 2) mixed experiences of previous support, and 3) needs within future support. Three main themes emerged from staff: 1) relationship difficulties and their impact, 2) support to be offered gently and thoughtfully, and 3) staff needs related to delivering this support.</p>
<p><em>Discussion:</em> YP struggle with a range of difficulties in families, friendships, and romantic relationships. The need for additional support to develop and maintain healthy relationships was corroborated by both staff and YP’s accounts. Support should be delivered in an individualised and sensitive manner according to each YP’s needs and preferences. Content of such support should include a focus on a range of topics related to relationships, including dependency, exploitation, abuse, online safety, and online relationships. The delivery of such support should make use of multimedia and a clearly defined content structure to promote engagement. An adaptation of a pre-existing relationships program, titled ‘Real Love Rocks’ (Barnardo’s, 2022) has been suggested as potentially meeting these needs. Staff require appropriate training opportunities to better equip them to deliver healthy relationship support to the YP within the YPSA.</p></br>
<p><strong>Theory-Driven Research Project</strong></p>
<p><strong>Exploring the impact of cognitive appraisals, anxiety, and falls concern in spinal cord injury rehabilitation</strong></p>
<p><em>Study design.</em> Cross-sectional, between-groups, questionnaire.</p>
<p><em>Objectives.</em> To investigate the impact of falls concern, anxiety, and cognitive appraisals on engagement in spinal cord injury rehabilitation.</p>
<p><em>Setting.</em> The National Spinal Injuries Centre (NSIC), Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, United Kingdom.</p>
<p><em>Methods.</em> Participants were inpatients at the NSIC. They completed a questionnaire comprising three measures. The Generalized Anxiety Disorder-7 (GAD-7) measured symptoms of anxiety, the Spinal Cord Injury-Falls Concern Scale (SCI-FCS) measured falls concern, and the Appraisals of DisAbility: Primary and Secondary Scale (ADAPSS) assessed cognitive appraisals. Engagement in rehabilitation was measured using the Hopkins Rehabilitation Engagement Rating Scale (HRERS), completed by participants’ physiotherapists. Correlational analyses and a hierarchical multiple regression were conducted.</p>
<p><em>Results.</em> Engagement in rehabilitation was not significantly correlated with cognitive appraisals of disability, falls concern, or generalised anxiety. The overall multiple regression model was not statistically significant.</p>
<p><em>Conclusions.</em> Cognitive appraisals of disability, falls concern, and generalised anxiety are not significantly correlated with or predictive of engagement in SCI/D rehabilitation. Engagement in rehabilitation was rated generally high. There was a high prevalence of falls concern and generalised anxiety. Suggestions for future research include considering other psychological factors which may predict engagement, conducting this research in settings with more varied engagement levels, and further exploring falls concern and its link with actual falls.</p>
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